Kitchen Design Questionnaire Form
General Information
Date ______
Name______
Address______
City/ State/ Zip______
Home Phone______
Work Phone______
Cell Phone______
E-Mail______
Industry Partners (Contractor/ Architect/ Designer) ______
Can the location of doors or windows be changed? Yes No
Which of our services are you interested in CKC providing: carpentry sheetrock electrical plumbing HVAC cabinetry counter tops appliances lighting flooring other______
How did you hear of Crystal Kitchen Center?______
Start or Completion date? ______
Age of home? ______
Style of home?______
How long do you plan on living in this home?______
What is your budget ______
Family and Lifestyle
How many are in your household? ______Ages?______
Do you want to plan for more that one cook in your new kitchen? Yes No
What is the height of the main cook?______
What do you dislike about your current kitchen?______
______
What do you like about your current kitchen?______
______
Secondary activities you would like to have take place in kitchen: Eating Laundry Wet Bar Hobbies Computer/Study Area Desk TV Seating area
Do you want an eat-in-kitchen? Yes No
If yes: Seating for how many? ______
Table (size) ______
Snack Bar: 30” high 36” high 42” high other______
How do you entertain: Formal Informal Buffet Cocktail Bar-B-Que
Other______
What size of gatherings would you like to accommodate?______
Do you have any pets: YesNo
Type______
How many______
What special accommodations, if any, would you like to make? ______
______
Cooking Style
Types of Cooking: Baking Gourmet Dishes Specialty cooking
Canning Family meals Quick& Simple Meals
Catering Other______
Small appliance storage: concealed on counter
Cooking Preference during entertaining: Alone Helper Group prep.
Are there any physical limitations you would like to plan for? Yes No
If so, what?
Needs
Storage:
PantryLinen storageRoll out shelves
Recycling center (sort)Lazy SusanSpice storage
Silverware dividersVeggie storageKnife drawer
Cookbook storageBread binMixer shelf
Tray storageTowel barGlass doors
Waste basketOpen shelvesChopping block
Bread boardTilt out sink front Appliance fronts
Pull out table Drawer dividers Appliance garage
Wine storage Other Other
Appliances and Fixtures Reuse Existing New Brand Name/Model Number
Refrigerator ______
Range ______
Wall oven ______
Cooktop ______
Microwave ______
Hood ______
Warming drawer ______
Steamer ______
Wine Cooler ______
Ice Maker ______
Beverage Center ______
Trash Compactor ______
Dishwasher ______
Sink ______
Disposal ______
Faucet ______
Pot filler faucet ______
Filter water faucet ______
Soap dispenser ______
Air Switch ______
Other ______
Design and Style
Style of new kitchen: Contemporary Traditional Transitional Rustic
Other
Color Preference______
Have you collected of magazine photos or list of ideas? Yes No
If so, please share with us.
List of priorities
- ______
- ______
- ______
If the design could be improved, would you be willing to make structural changes:
(Windows, doors and walls) YesNo
Cabinet Preference ______
Counter Top Preference______
Backsplash Preference______
Flooring Preference______
Lighting Preference______
Decorative Surfaces (walls, ceiling) Preference______
Circle 3 words to describe your new kitchen:
Some of our descriptive words…
Airy / Bold / Bright / Calming / Cheery / Classic / Clean / ComfortableColorful / Cool / Country / Cozy / Casual / Cluttered / Crisp / Contemporary
Dynamic / Dark / Different / Dramatic / Ethnic / Exotic / Energetic / Distinguished
Eclectic / Easy / Elegant / Exciting / Feminine / Formal / Fresh / Friendly
Grand / Fun / Gracious / Happy / Informal / Inviting / Light / Humorous
Lived-in / Open / Masculine / Modern / Natural / Personal / Pretty / Mysterious
Powerful / Quiet / Refreshing / Relaxing / Romantic / Rustic / Rich / Pampering
Sensual / Soft / Serene / Simple / Sparse / Stable / Stylish / Sophisticated
Striking / Warm / Tailored / Timeless / Tropical / Tranquil / Unique / Traditional
Vibrant / Wow / Whimsical / Youthful / Zen